This is just an incidental anecdote, but I assume others here can relate to it.

I keep my daily pills (Ultram ER, Verapamil, multivitamin) in a weekly pill organizer beside my bed. The first thing I do every morning is take that day's pills.

Somehow, on Wednesday I forgot to take my pills. That has happened perhaps three times since I started taking meds daily, years ago. I realized this only last night when I started to refill the organizer for the upcoming week.

Fortunately, my heart didn't give me any trouble, but Wednesday was a very bad pain day. I had attributed it to it being a cold day, my doing the shopping, and then spending most of the afternoon cooking a chicken soup from scratch (I added lemongrass to the recipe this time -- yum).

Well, I was chasing pain all day. I took 10mg hydrocodone in the morning, then another 5mg around noon. I was quite sore after returning from the supermarket around 3pm and at some point between then and 5pm, as I was going from one stage of the soup prep to the next, I took 10mg of oxycodone -- I was in agony from chopping.

The soup was great, but I had no appetite. At 8pm, I was still in tons of pain and so pulled out my Nucynta, from over a year ago, as other opioids wire me and this one would give me the best shot at getting to sleep.

I believe that was the first time I took 3 BT doses in one day. But one thing it does suggest, given that I forgot my Ultram ER, is that however insufficient, it is still making a difference. C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

I have forgot my meds once or twice and I know what you mean by chasing pain all day....that is the same way it was for me...who would think we could ever forget our meds...lol...I think we get forgetful from meds.

Take Care, AmyChronic Pain(nerve), fibro, mild depression and a few others